Why a lack of ASCs could be driving up healthcare costs in Massachusetts

Massachusetts' high healthcare prices and the financial burden it has consequently placed on patients is causing state lawmakers to take a hard look at healthcare spending, WBUR reported June 8.

Massachusetts' per-capita commercial healthcare spending increased an average of 5 percent between 2019 and 2021, which is more than one point above the national growth rate and twice the rate by which incomes rose during that time, according to the Massachusetts Health Policy Commission. 

David Auerbach, PhD, HPC senior director for research and cost trends, told WBUR that the main drivers of major cost growth were higher-than-necessary spending and more use of healthcare services than expected.

According to an annual report from the HPC that will be released in full in September, the areas that contributed to more than $3 billion in commercial excessive spending in 2021 could be attributed to prescription drugs, labs, specialty services, imaging, endoscopies and colonoscopies, inpatient stays and clinician-administered drugs. 

Mr. Auerbach told WBUR that in several cases, those services charged more than twice as much as what Medicare would pay as the benchmark, representing about one-eighth of all of the state's medical expenditures.

One big healthcare expense that the state has to deal with is hospitalizations. Though hospitals are a necessary part of any community, they do not need to be the only line of defense. 

Many procedures, such as joint replacements and colonoscopies, can be performed in an ASC, depending on the individual. However, Massachusetts has just 59 ASCs licensed by the Department of Public Health, according to WBUR. This makes Massachusetts the state with the sixth-fewest ASC per capita.

Dr. Auerbach presented data to WBUR showing that some surgeries, including lens and cataract procedures and arthroscopies, are on average about 75 percent more expensive in hospital outpatient departments than ASCs. 

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